| NPI | 1578523643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G63732) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301064488) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 23D2013964) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2013-11-13 |