| NPI | 1093151482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 60955) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MA 274616) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 274616) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2020-06-09 |