| NPI | 1194971622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D0071698) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MD D0071698) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2023-09-06 |