| NPI | 1285633024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SD 2059) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA 26475) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 12180) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2013-02-25 |