| NPI | 1558627521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 20A11074) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: CA 20A11074) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2021-12-27 |