| NPI | 1154475101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: ND 11718) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SD 7916) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 52622) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-11-10 |