| NPI | 1407207897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX V4485) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: WI 77106-20) |
| 207ZD0900X Pathology, Dermatopathology (Licence: WI 77106-20) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 77106-20) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2024-11-04 |