NPI | 1962566059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZF0201X Pathology Forensic Pathology (Licence: PA MD016783E) |
Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD016783E) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2007-07-08 |