| NPI | 1811929169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX G6554) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 11249) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 023296) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |