| NPI | 1083668453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 53375) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 257784) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CT 044080) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2015-09-23 |