| NPI | 1154488062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX N6561) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MT181938) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D66835) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2011-02-11 |