| NPI | 1144562125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX V4705) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MO 2018025131) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2025-01-07 |