| NPI | 1083690168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AZ 78495) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME118445) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2025-10-22 |