NPI | 1609252881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61157457) |
Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA a143837) |
Enumeration Date | 2015-08-10 |
Last Update Date | 2023-01-04 |