| NPI | 1699949586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD440107) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 200800973) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 104361) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2013-05-17 |