| NPI | 1558413237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: MA 79929) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: IL 036104920) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2016-05-18 |