| NPI | 1538260674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 37598) |
| Additional Taxonomies | 207ZP0104X Pathology Chemical Pathology (Licence: MA 37598) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-10-26 |