| NPI | 1679202592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 87672) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: SC 87672) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |