| NPI | 1194101337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX 47653) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX 47563) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2023-01-26 |