| NPI | 1538164512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX K9929) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: TX K9929) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-07-12 |