| NPI | 1649365370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101264914) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2004015955) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MS 21121) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-06-14 |