| NPI | 1538230834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC TL30539) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX M0318) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-10-22 |