| NPI | 1447399464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: CO 46671) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: ID M-10708) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: ID M-10708) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2021-06-03 |