| NPI | 1063795938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 51938) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: CA A123221) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2020-10-15 |