| NPI | 1699118075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 286685) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A135429) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2023-03-04 |