| NPI | 1386999191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 48982) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TN 57469) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-08-29 |