| NPI | 1548240526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX E6034) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX E6034) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-07-21 |