| NPI | 1891988283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N8023) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: TX N8023) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2016-02-12 |