| NPI | 1568624922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 069428) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME 111521) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-04-27 |