| NPI | 1336645811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL 161506) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 68588) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-06-15 |