| NPI | 1104881358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2009028900) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME89993) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 04-33965) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2016-03-25 |