| NPI | 1346212313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 261QM1300X) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: VA 0101224785) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2013-12-19 |