| NPI | 1285791541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD00024002) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CO DR-21673) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-10-29 |