| NPI | 1811283922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX T7950) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX T7950) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D81221) | |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: TX T7950) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-07-11 |