| NPI | 1932167624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology Pediatric Pathology (Licence: MO 2023015880) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: GA 050760) |
| 207ZP0213X Pathology Pediatric Pathology (Licence: GA 050760) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2023-05-17 |