| NPI | 1164586707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN MD40578) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 110361) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A93744) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: WI 66456-20) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2025-10-17 |