| NPI | 1730184136 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX K2942) | 
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX K2942) | 
| Enumeration Date | 2005-06-14 | 
| Last Update Date | 2025-03-03 |