| NPI | 1710920863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NV 10593) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OR MD21522) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G78174) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-04-17 |