| NPI | 1750373791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101029228) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: VA 0101029228) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2011-06-16 |