| NPI | 1932679214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OK 37896) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: UT 11017906-1205) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2021-08-19 |