NPI | 1467569103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX F5375) |
Additional Taxonomies | 174400000X Specialist (Licence: CA C52355) |
207ZP0101X Pathology, Anatomic Pathology (Licence: CA C52355) | |
207ZP0101X Pathology, Anatomic Pathology (Licence: ME 009580) | |
Enumeration Date | 2006-08-25 |
Last Update Date | 2012-07-25 |