| NPI | 1205918182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology Pediatric Pathology (Licence: FL ME108507) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: FL ME108507) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: FL ME108507) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2010-12-05 |