| NPI | 1447660154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: UT 12366425-1205) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A139005) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2021-10-19 |