| NPI | 1174746903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NH 17803) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: NH 17803) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2017-02-14 |