| NPI | 1306005442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C209165) |
| Additional Taxonomies | 207ZC0008X Pathology, Clinical Informatics Specialist (Licence: CA C209165) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: CA C209165) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2026-06-01 |