| NPI | 1851340749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301106357) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 044054) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2019-09-26 |