| NPI | 1396776258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MS 13676) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 13676) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD00026584) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-05-12 |