| NPI | 1336146240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: PA MD026513E) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PA MD026513E) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-07-06 |