| NPI | 1609982008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DC MD30643) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101033348) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-07-21 |