| NPI | 1144250705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.016641) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D0067018) |
| 207Q00000X Family Medicine (Licence: LA 016641) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-09-12 |