| NPI | 1891922951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: UT 5304262-1205) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 40720) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2020-11-05 |