| NPI | 1669522926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 83540) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D70746) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2024-03-22 |