| NPI | 1215022827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: MA 76910) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: MA 76910) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 76910) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |