| NPI | 1043229214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: MA 40037) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 40037) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: MA 40037) | |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2007-08-20 |