| NPI | 1952511404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 38179) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA R-7507) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 52728) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2010-03-19 |