| NPI | 1891730305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: MA 57808) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 57808) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 57808) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2021-06-03 |