NPI | 1578562575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME60205) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 153567) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2025-02-19 |