| NPI | 1134164858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G85981) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 209351-1) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35-03-9883-R) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2007-07-08 |