| NPI | 1710966304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD058474L) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: PA MD058575L) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2018-04-05 |