| NPI | 1376572602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A70666) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A70666) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2012-06-18 |