| NPI | 1093787293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL OS0005468) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: FL OS0005468) |
| 207ZC0500X Pathology Cytopathology (Licence: FL OF0005468) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2007-08-30 |