| NPI | 1376577908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: IA 40247) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: HI 15593) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2012-11-08 |