| NPI | 1033159629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 40377) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 40377) |
| 174400000X Specialist (Licence: CA A93586) | |
| 174400000X Specialist (Licence: WV 22149) | |
| 174400000X Specialist (Licence: VA 0101237736) | |
| 174400000X Specialist (Licence: IN 01061271 A) | |
| 174400000X Specialist (Licence: MI 4301085213) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2021-03-30 |