| NPI | 1396945838 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 242614) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 232371) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2018-03-21 |