| NPI | 1336109461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: FL ME37835) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: FL ME37835) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME37835) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2007-07-08 |