| NPI | 1770585903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MT 6816) |
| Additional Taxonomies | 207ZP0007X Pathology Molecular Genetic Pathology (Licence: MT 6816) |
| 207ZC0500X Pathology Cytopathology (Licence: MT 6816) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2008-09-04 |