| NPI | 1659308773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101262102) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2017-00283) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME0071774) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2017-03-27 |