| NPI | 1003837600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OK 16319) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 04-28864) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301039358) | |
| 207ZP0104X Pathology Chemical Pathology (Licence: OK 16319) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-08-13 |