| NPI | 1225052202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 32673) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 27643) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WY 9104A) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-04-08 |