| NPI | 1467412155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: TX G5384) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX G5384) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2023-01-29 |