| NPI | 1215973581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD46803) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 26980) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: TN MD46803) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2015-05-28 |