| NPI | 1619958998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: AZ 71420) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 54427) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA C129537) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2023-11-07 |