| NPI | 1518182674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AL MD.30117) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO DR.0064247) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2022-03-09 |