| NPI | 1700142569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology Pediatric Pathology (Licence: CO DR.0056458) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO DR.0056458) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2018-08-20 |