| NPI | 1104974815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZI0100X Pathology, Immunopathology (Licence: MI 4301046445) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301046445) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |