| NPI | 1568662583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: KY 03341) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: KY 03341) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2021-02-22 |