| NPI | 1427476761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: WA MD61355090) |
| Additional Taxonomies | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WI 71201-20) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2023-04-11 |