| NPI | 1861474850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME01345) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: FL ME01345) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2007-12-10 |