| NPI | 1568616084 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2018-01704)  | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY R1436)  | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR E-7967)  | |
| Enumeration Date | 2008-11-11 | 
| Last Update Date | 2018-07-19 |