| NPI | 1043285349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 30691) |
| Additional Taxonomies | 207ZP0104X Pathology Chemical Pathology (Licence: NC 30691) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2008-01-15 |