| NPI | 1760864300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2022-0751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2015017866) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2024-05-09 |