| NPI | 1285617407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 63410) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CT 039224) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2018-04-24 |