| NPI | 1073519393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 93-00702) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 265672) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G65531) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 9300702) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 221876) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2025-05-08 |