| NPI | 1053389171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301067551) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301067551) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2008-10-02 |