| NPI | 1093918021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D71661) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: DE C1-0009592) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2012-01-05 |