NPI | 1396139549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61071246) |
Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 65651) |
Enumeration Date | 2015-03-26 |
Last Update Date | 2020-06-24 |