| NPI | 1467643643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N9864) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX BP1-0029086) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-10-22 |