| NPI | 1386603413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00037489) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WA MD00037489) |
| 207ZM0300X Pathology, Medical Microbiology (Licence: WA MD00037489) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2007-12-18 |