| NPI | 1396169892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD.00008814) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA MD00008814) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-05 |