| NPI | 1104038272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D80168) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A101679) |
| 174400000X Specialist (Licence: MA 222456) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2026-03-16 |