| NPI | 1417064403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME105199) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX J4806) |
| 207R00000X Internal Medicine (Licence: TX J4806) | |
| 207ZC0500X Pathology, Cytopathology (Licence: TX J4806) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2009-12-17 |