| NPI | 1952716276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 1412) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 5249) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0102207658) | |
| 208D00000X General Practice (Licence: NE 1412) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2025-12-18 |