| NPI | 1376532754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: MA 58578) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G137100) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2020-10-12 |