NPI | 1558353300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: OR MD224171) |
Additional Taxonomies | 174400000X Specialist (Licence: NC 25750) |
Enumeration Date | 2005-08-18 |
Last Update Date | 2025-05-22 |