| NPI | 1548325152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G32807) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G32807) |
| 208000000X Pediatrics (Licence: CA G32807) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2024-03-13 |