| NPI | 1073007498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX V1640) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX V6140) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2026-06-24 |