| NPI | 1639129059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 038155) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: GA 038155) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-09-11 |