| NPI | 1649443128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR T2014-021) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2006014654) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2014-03-19 |