| NPI | 1942213590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: CA G20801) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: CA G20801) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA G20801) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-09 |