| NPI | 1932988052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 48950) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX H-4741) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2024-06-03 |