| NPI | 1316961618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MED-PHYS-LIC-9847) |
| Additional Taxonomies | 174400000X Specialist (Licence: MT 9847) |
| 207ZC0006X Pathology, Clinical Pathology (Licence: MT MED-PHYS-LIC-9847) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-02-19 |