| NPI | 1922095751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: TN MD005138) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: GA 029275) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2008-10-22 |