| NPI | 1770519555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2004029637) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2004029637) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2024-08-08 |