| NPI | 1073709747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AZ 48378) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G77251) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2014-06-06 |