| NPI | 1891958245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 40218) |
| Additional Taxonomies | 207ZP0007X Pathology Molecular Genetic Pathology (Licence: IA 40218) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2014-06-02 |