| NPI | 1205367190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD61269872) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61269872) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2022-11-16 |