| NPI | 1457354656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 036-116729) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: TN 16605) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2019-08-22 |