| NPI | 1306841085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: DC MD048071) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: TX J0899) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-05-29 |