| NPI | 1538363171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ME MD19249) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: HI 4754) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2012-08-02 |