| NPI | 1386755809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 13423479-1205) | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD429260) | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.205664) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 21356) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME154997) | |
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2023-05-25 |