| NPI | 1972525194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 39750) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX P1245) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME92311) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-07-21 |