| NPI | 1730685447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D0096190) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: DC MD00003299) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2024-07-05 |