| NPI | 1255469250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX 48060) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CO DR.006135) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CO DR.0061357) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2024-02-27 |