| NPI | 1790865467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME105005) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: FL ME105005) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2025-07-30 |