| NPI | 1437392289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO 58022) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WY 10866A) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE 29801) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2020-03-24 |