| NPI | 1023098928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN MD47889) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 231963) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2016-05-12 |