| NPI | 1316127905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 14944) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 9300334) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D68894) | |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2023-09-15 |