| NPI | 1154345122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301051583) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: MI 4301051583) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC TL27120) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: MI 4301051583) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-11-11 |