| NPI | 1700883212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 31960) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NC 31960) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2010-05-12 |