| NPI | 1265492086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 42928) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MN 42928) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2018-07-09 |