| NPI | 1710199021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301098138) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: MI 4301098138) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2012-07-05 |