| NPI | 1821207432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N3411) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301082085) |
| 207ZC0500X Pathology, Cytopathology (Licence: TX N3411) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2011-02-09 |