| NPI | 1184631871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 31564) |
| Additional Taxonomies | 207ZI0100X Pathology Immunopathology (Licence: KY 31564) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-05-28 |