| NPI | 1215198908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 68947) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 68947) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-10-14 |