| NPI | 1104052653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: UT 8978824-1205) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: UT 8978824-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD186792) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2024-01-09 |