| NPI | 1427115369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60280473) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA08734200) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 79830) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD436170) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2026-02-27 |