| NPI | 1093391575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 87592-20) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: WI 87592-20) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 1093391575) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: WI 87592-20) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-07-29 |