| NPI | 1184995987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX S2735) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101249656) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: TX S2735) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2022-01-26 |