| NPI | 1669009015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2026-00927) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: NC 2026-00927) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-07-17 |