| NPI | 1063617751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 248507) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MI 4301089297) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2009-03-26 |