| NPI | 1306462932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME173545) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4351046364) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL 977806) | |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2025-07-14 |