| NPI | 1922185602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology Forensic Pathology (Licence: KY 24672) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 24672) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-05-28 |