| NPI | 1235570615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A168641) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: PA MD460931) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD460931) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2021-01-12 |