| NPI | 1861442550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology Forensic Pathology (Licence: UT 315477-1205) |
| Additional Taxonomies | 207ZF0201X Pathology Forensic Pathology (Licence: SC 23071) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 23071) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-08-13 |