| NPI | 1063634905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: AL 26143) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 26143) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-05-31 |