| NPI | 1639385180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A100251) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: CA A100251) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-05-16 |