| NPI | 1033113865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 5724) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G67362) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM 82-321) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 172972-1205) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2010-03-16 |