| NPI | 1124001912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 031560) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 031560) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2008-08-04 |