| NPI | 1528354883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 201800847) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 52043) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 52043) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 201800847) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2026-08-11 |