| NPI | 1043200967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME77592) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AZ 47248) |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2020-10-08 |