| NPI | 1124034814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: CA G56930) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA G56930) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-10-28 |