| NPI | 1467519454 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60416900) | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MED-PHYS-LIC-27714) | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK 8262) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID M-12267) | |
| Enumeration Date | 2007-01-02 | 
| Last Update Date | 2025-09-30 |