NPI | 1922412048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME155122) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA L-259065) |
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A163144) | |
Enumeration Date | 2014-06-17 |
Last Update Date | 2022-08-01 |