NPI | 1164629713 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: VA 0101257810) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2007-06-28 |
Last Update Date | 2024-02-01 |