| NPI | 1265518351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60213672) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL trn10061) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2014-01-15 |