| NPI | 1922098458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZI0100X Pathology Immunopathology (Licence: MA 31561) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MA 31561) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-08 |