| NPI | 1508240342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 277735) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 263811) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2024-04-10 |