| NPI | 1174109201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 1018285) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A203466) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2025-09-05 |