| 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: MN 50050) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT181823) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2022-01-27 |