| NPI | 1255660197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: VA 0101244511) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: DC MD038226) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2009-12-23 |