| NPI | 1578092524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: IA MD-48200) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 12762273-1205) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-04-20 |