| NPI | 1871955021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM MD2021-0446) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 11753392-1205) |
| 207ZC0006X Pathology, Clinical Pathology (Licence: UT 11753392-1205) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2023-10-16 |