| NPI | 1306368584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: ME MD24411) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 272240) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-07-21 |