| NPI | 1093973943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME121699) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DC MD040420) |
| 207ZC0006X Pathology, Clinical Pathology (Licence: FL ME121699) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2023-06-12 |