| NPI | 1518955319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: NC 2013-00575) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: IA 33078) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2014-02-06 |