| NPI | 1174780878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101248955) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 200701778) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2021-04-18 |