| NPI | 1134183593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO 33376) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: CO 33376) |
| 207ZC0500X Pathology, Cytopathology (Licence: MO R8P37) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO R8P37) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2007-12-17 |