| NPI | 1346222536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: DC MD206468) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D0045364) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101054299) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2011-11-04 |