| NPI | 1154305324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: MN 59179) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 59179) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2022-07-21 |