| NPI | 1548524044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME135457) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN17550) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 61614) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2018-06-28 |