| NPI | 1295221034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301114665) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY P115195) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2022-06-12 |