| NPI | 1538121371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX G3633) |
| Additional Taxonomies | 207ZF0201X Pathology Forensic Pathology (Licence: TX G3633) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-12-05 |