| NPI | 1659571057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301071804) |
| Additional Taxonomies | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: MI 4301071804) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2012-08-03 |