| NPI | 1013966563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: VA 0101044312) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101044312) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-07-08 |