| NPI | 1215159199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: IA 39829) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 239546) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-11-07 |