| NPI | 1720020118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY TP036) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301082783) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N4570) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-04-22 |