| NPI | 1699053397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G44436) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: CA G44436) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G44436) | |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |