| NPI | 1891998365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M66667) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX NA) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101242878) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2024-03-04 |