| NPI | 1528263175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 20A11754) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: TX BP2-0019923) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 3974) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2024-07-22 |