| NPI | 1770559502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 34707) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2002005137) |
| 207ZC0500X Pathology Cytopathology (Licence: TN 34707) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2010-03-16 |