| NPI | 1376868331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: VA 0101252193) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D0069883) |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2021-05-05 |