| NPI | 1487958815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61229242) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 25352) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX P1422) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A133795) | |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2021-12-28 |