| NPI | 1063679405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA OS015198) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: PA OS015198) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2020-10-02 |