| NPI | 1437236429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: IA 39100) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WI 48403-020) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MN 51099) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-08-11 |