| NPI | 1265484646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2018025919) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.09734R) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-05-05 |