| NPI | 1265667216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: IL 036.125796) |
| Additional Taxonomies | 207ZF0201X Pathology Forensic Pathology (Licence: IL 036.125796) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2016-01-11 |