| NPI | 1326273772 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: UT 12182888-1205)  | 
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: CT 050631)  | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 050631)  | |
| Enumeration Date | 2009-05-28 | 
| Last Update Date | 2022-03-17 |