| NPI | 1346761939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 66134) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 28198) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 28198) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |