| NPI | 1669531190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301509920) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 213373) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-12-05 |