| NPI | 1063748440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2009026071) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 42187) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD435274) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |