NPI | 1598811374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AL 25183) |
Additional Taxonomies | 208D00000X General Practice (Licence: AL 25183) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2009-04-27 |