| NPI | 1235579293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 53563) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: AZ 53563) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2020-08-04 |