| NPI | 1275562480 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: GA 053855) | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 053855) | 
| Enumeration Date | 2006-07-01 | 
| Last Update Date | 2007-09-14 |