| NPI | 1053361253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 9227) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: SC 9227) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: SC 9227) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2013-10-31 |