| NPI | 1487706230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 41126) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD053540L) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 47553) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-04-27 |