| NPI | 1992778583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME0024824) |
| Additional Taxonomies | 207ZN0500X Pathology Neuropathology (Licence: FL ME0024824) |
| 207ZC0500X Pathology Cytopathology (Licence: FL ME0024824) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-08-30 |