| NPI | 1083138911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD476163) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA R-10810) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA MD-48061) | |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-07-21 |