| NPI | 1285741090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G61364) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G61364) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-06-24 |