| NPI | 1295970481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 41869) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: KY 41869) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2020-06-24 |