| NPI | 1659562676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 201600534) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 2160271) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD425446) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2016-06-16 |