| NPI | 1245640564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AR E-12357) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX BP10050661) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 292421) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2019-07-02 |