| NPI | 1366768848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 2016-01680) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 39960) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2018-04-09 |