| NPI | 1013062850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ME 017501) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD428108) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A98612) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-23 |