| NPI | 1669648408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 27457) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01065131A) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301510501) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: NY 313196-01) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2025-07-18 |