| NPI | 1215902143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: FL ME55071) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: FL ME55071) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME55071) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-09-18 |