| NPI | 1821035452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: MA 58606) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 58606) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-07-21 |