| NPI | 1326359258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME153681) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 54252) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 54252) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2021-12-14 |