NPI | 1972690907 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ME MD23532) |
Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MI 01104300) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2020-08-05 |