| NPI | 1174605117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301043311) |
| Additional Taxonomies | 207ZI0100X Pathology, Immunopathology (Licence: MI 4301043311) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2012-03-22 |