| NPI | 1124027925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: LA MD.016115) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: LA L#016115) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2008-11-05 |