| NPI | 1972812972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: NM MD2012-0021) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: TX L6575) |
| Enumeration Date | 2010-09-25 |
| Last Update Date | 2013-08-15 |