| NPI | 1598217713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: MN 64657) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 27586) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2018-10-09 |