| NPI | 1871850792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: FL 54359) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: NY 246691) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-04-16 |