| NPI | 1891998399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX p5750) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: TX p5750) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2013-04-23 |