| NPI | 1851427686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WA MD00048792) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA L-221417) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2018-02-14 |