| NPI | 1235175373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX R0289) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 39246) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 39246) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2022-07-21 |