| NPI | 1548470966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D71480) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MT190811) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D71480) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-03-01 |