| NPI | 1922367978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: MS 28746) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AR E-9770) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2021-09-13 |