| 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 |