| NPI | 1760454284 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME124617) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD028023E) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 188249-1) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-02-23 |