| NPI | 1083733513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 49819) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MN 49819) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 49819) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-10-06 |