| NPI | 1952801086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WV 28883) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD459894) |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2022-04-13 |