| NPI | 1174599039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00032601) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: WA MD00032601) |
| 207ZD0900X Pathology, Dermatopathology (Licence: WA MD000032601) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2008-01-02 |