| NPI | 1366541765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WV 18130) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: WV 18130) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-05-24 |