| NPI | 1457795270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CT 73109) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A139745) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 29931) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2023-01-11 |