| NPI | 1376598482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00046787) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NM 99-299) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 4827321-1205) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2007-07-08 |