| NPI | 1417938705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: MA 152633) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 152633) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2011-07-18 |