| NPI | 1003917782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 14073) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 6276) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IN 01037234) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-13 |