| NPI | 1235150749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G78575) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 15663) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME92769) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD200393) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |