| NPI | 1801155742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 33164) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 33164) |
| Enumeration Date | 2012-05-13 |
| Last Update Date | 2018-02-06 |