| NPI | 1871654467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OR MD17936) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: OR MF-17936) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2014-11-03 |