NPI | 1003166935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO R1C36) |
Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: MO R1C36) |
Enumeration Date | 2012-09-18 |
Last Update Date | 2012-09-18 |