| NPI | 1942417787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N1799) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD430650) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 53269) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2014-10-29 |