| NPI | 1538364104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TX BP1-0022237) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 7359483-1205) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2013-03-28 |