| NPI | 1275570996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO MDR3E24) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MO MDR3E24) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2008-02-20 |