| NPI | 1962407189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NC 9300397) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: NC 9300397) |
| 207ZC0500X Pathology Cytopathology (Licence: NC 9300397) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2019-03-12 |