| NPI | 1003882127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: LA MD.203477) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD067986L) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2017-04-05 |