| NPI | 1811052863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD154288) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60290250) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD430045) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2026-06-17 |