| NPI | 1639144256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: IN 01054108A) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: PA MD046799L) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2026-08-06 |