| NPI | 1609150945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZF0201X Pathology Forensic Pathology (Licence: AZ 27806) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ 27806) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |