| NPI | 1407246226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301501908) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 4301501908) |
| 207ZC0500X Pathology, Cytopathology (Licence: DC MD045329) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DC MD045329) | |
| Enumeration Date | 2015-02-01 |
| Last Update Date | 2020-05-08 |