| NPI | 1124092804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: KS 04-19124) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MO R2J39) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2013-12-11 |