| NPI | 1427075225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OK 19728) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 04-26257) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX H9839) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2007-07-09 |