| NPI | 1184724080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD-435463)  | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 051529)  | 
| Enumeration Date | 2006-09-22 | 
| Last Update Date | 2023-11-29 |