| NPI | 1770562951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 06765) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MS 06765) |
| 207ZP0104X Pathology, Chemical Pathology (Licence: MS 06765) | |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2008-12-17 |