NPI | 1891363388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 5151017078) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 289493) |
208D00000X General Practice (Licence: MA 289493) | |
Enumeration Date | 2021-06-11 |
Last Update Date | 2024-06-24 |