| NPI | 1932117710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME108452) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WV 22160) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WV 22160) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-11-29 |