| NPI | 1962517045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 52535) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 2011-01924) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-09-25 |