| NPI | 1558503870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO DR.0055264) |
| Additional Taxonomies | 207ZP0104X Pathology Chemical Pathology (Licence: CO DR.0055264) |
| 207ZP0213X Pathology Pediatric Pathology (Licence: CO DR.0055264) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2025-07-31 |