| NPI | 1336213552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D0022025) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DE C1-0005172) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2016-08-16 |