| NPI | 1912973330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: WY 5471A) |
| Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: WY 5471A) |
| Enumeration Date | 2006-02-25 |
| Last Update Date | 2008-05-01 |