| NPI | 1992382212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL MD.47887) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA 61660997) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-06-22 |