| NPI | 1063432987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME44526) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME44526) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-02-23 |