| NPI | 1962670521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA MD-43130) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA GETP.TUL.PTH) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME107425) | |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2023-12-26 |