| NPI | 1881871275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 55719) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MN 106349) |
| 174400000X Specialist | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2020-10-06 |