| NPI | 1528099272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 56750) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 56750) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D56360) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-10-06 |