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 |