| NPI | 1073664017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 60117) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G64560) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |