| NPI | 1831113760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX U0660) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 16878) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-01-18 |