| NPI | 1689747792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NH 15362) |
| Additional Taxonomies | 174400000X Specialist (Licence: MT 10853) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-04-13 |