| NPI | 1780953521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: MD D87525) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: CA A136974) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2022-11-03 |