| NPI | 1144673591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 63106) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TN 63106) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2016017336) | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2022-03-26 |