| NPI | 1538665575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: MT MED-PHYS-LIC-162042) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME163162) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 87160) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2026-03-12 |