| NPI | 1386868495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301099864) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 243552-1) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2023-10-25 |