| NPI | 1265835110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301104425) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MI 4301104425) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2023-10-26 |