| NPI | 1750517330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101260185) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: PA MT195871) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 8566738-1205) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2016-06-17 |