| NPI | 1821027640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 68660) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D0063352) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2023-12-13 |