| NPI | 1760670285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA 60022117) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: CA A88725) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A88725) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2009-07-29 |