| NPI | 1982067039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: MI 4301506004) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: IA MD-46582) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA MD-46582) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-10-24 |