| NPI | 1063687564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 2008-01907) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 65680) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AL 33109) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 134706) | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2024-02-06 |