| NPI | 1174641328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZI0100X Pathology Immunopathology |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |