| NPI | 1780023101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WI 70567) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: IL 036.142095) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 70567) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: WI 70567) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2022-02-04 |