| NPI | 1477045219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: TX T4926) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX BP10063421) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2023-07-10 |