| NPI | 1639317308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2011-01022) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: SC 34271) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2018-04-16 |