| NPI | 1073610754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: LA 016061) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 17902) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 33861) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2018-07-03 |