| NPI | 1871552901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX J1108) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX J1108) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TX J1108) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2018-03-27 |