| NPI | 1215023767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME161572) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A43788) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2021-1022) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-10-16 |