| NPI | 1508089475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME133854) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MN 49758) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-01-25 |