NPI | 1841405487 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX U3864) |
Additional Taxonomies | 208D00000X General Practice (Licence: IN 02003180A) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2023-08-14 |