| NPI | 1003907775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 35914) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 036597) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 39446) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-13 |