| NPI | 1821077835 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL OS0007534) | 
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: FL OS0007534) | 
| Enumeration Date | 2006-01-10 | 
| Last Update Date | 2016-03-16 |