| NPI | 1225411556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2021-00216) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL37661) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2021-05-28 |