| NPI | 1871639419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 13802) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: WV 13802) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-12-18 |