| NPI | 1558375220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AL MD.10166) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: LA 11552R) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2006000543) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-01-20 |