| NPI | 1922453091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 20A16287) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA 20A16287) |
| 207ZH0000X Pathology, Hematology (Licence: CA 20A16287) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2024-03-13 |