| NPI | 1104567130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT228366) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 125079263) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-05-17 |