| NPI | 1205891678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: KY 33752) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: KY 33752) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-01-04 |