| NPI | 1407815657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology |
| 207ZH0000X Pathology Hematology | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2007-10-11 |