| NPI | 1760748065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D89396) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 66074) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 7248) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2021-08-03 |