| NPI | 1508079658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NC 2008-01686) |
| Additional Taxonomies | 207ZF0201X Pathology Forensic Pathology (Licence: NC 2008-01686) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2013-03-28 |