| NPI | 1356368211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD424507) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD424507) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2018-04-17 |