| NPI | 1669554648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301032646) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301032646) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-12-04 |