| NPI | 1023055209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 20193) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD 067762 L) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX K8137) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2010-07-15 |