| NPI | 1790993459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 55634) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD442433) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 243690) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2016-11-07 |