| NPI | 1790731651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: VT 042-0015453) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301087243) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-08-25 |