| NPI | 1801320031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology Pediatric Pathology (Licence: AZ 72827) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: TX 47672) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2024-08-23 |