| NPI | 1619956604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301087086) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MN 33135) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2019-08-05 |