| NPI | 1588754113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 13053) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: UT 185037-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 41457) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-05-01 |