| NPI | 1962504134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology Pediatric Pathology (Licence: AL MD.16891) |
| Additional Taxonomies | 207ZP0213X Pathology Pediatric Pathology (Licence: TX L0801) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2021-01-15 |