| NPI | 1669508420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 56216) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA L-221200) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: WI 56216) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2011-09-02 |