| NPI | 1578543369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: AZ 831843) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: UT 49131071205) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-10-02 |