| NPI | 1699018440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME141374) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD459692) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME141374) | |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2019-06-24 |