| NPI | 1164602611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 70094) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID M-10161) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2007-00176) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2019-10-28 |