| NPI | 1023210762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: CA G62190) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G62190) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-08 |