| NPI | 1750482642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: MA 78014) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MA 78014) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2021-06-18 |