| NPI | 1942457510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 62773) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 239299) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2017-03-01 |