| NPI | 1356584106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OR MD171633) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 41862) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A115581) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2019-08-08 |