| NPI | 1265459960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 18120) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 04-23927) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX H4387) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-06-30 |