| NPI | 1902260961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 282359) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: MA 282359) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-10-07 |