| NPI | 1851312516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 9947) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 04-17787) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 34571) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-09 |