| NPI | 1235371691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 04-45362) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2014007653) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2022-05-16 |