| NPI | 1750795282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX T9827) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME135918) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2019009595) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2022-11-02 |