| NPI | 1104034164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N5415) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX N5415) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2014-10-30 |