| NPI | 1164964466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A162607) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A162607) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2024-03-13 |