| NPI | 1962585463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 2012-00824) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: PA MD073322L) |
| 207ZC0500X Pathology Cytopathology (Licence: NC 2012-00824) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD073322L) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-12-16 |