| NPI | 1770504797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: TN MD41600) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 18091) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD41600) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2022-03-29 |