| NPI | 1730146713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: GA 051766) |
| Additional Taxonomies | 207ZP0213X Pathology Pediatric Pathology (Licence: GA 051766) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2008-11-03 |