| NPI | 1326027871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 46783) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: NY 238779) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 106788) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-07-20 |