| NPI | 1497133649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX BP10053405) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AR E-14941) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2021-12-01 |