| NPI | 1720585904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: UT 11405433-1205) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 11405433-1205) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2021-12-17 |