| 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 |