| NPI | 1538512231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 278394) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: RI MD17375) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 267112) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2021-04-08 |