| NPI | 1790892594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 16481) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 40019) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA C54057) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-07-09 |