| NPI | 1649269028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 69135) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MA 153609) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2021-10-28 |