| NPI | 1144431883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR E 8126) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX R3298) |
| 208D00000X General Practice (Licence: MO 2013042434) | |
| 208D00000X General Practice (Licence: AR E-8126) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-05-19 |