| NPI | 1528158011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: AR E2696) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: AR E2696) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AR E2696) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-01-08 |