| NPI | 1316991987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101053620) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: VA 0101053620) |
| 207ZP0104X Pathology, Chemical Pathology (Licence: VA 0101053620) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-07-10 |