| NPI | 1376670679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 51763) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 001851-1) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 51763) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-10-06 |