| NPI | 1174503494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101-241204) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: GA 026285) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2014-12-22 |