| NPI | 1346694247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61621538) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 11741862-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MEDPHYSCOMLIC146163) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID 2861075) | |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2025-09-30 |