| NPI | 1164465324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NV 5606) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A43810) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 170319-1205) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-04-17 |