| NPI | 1033300454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301091934) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: MI 4301091934) |
| 207ZC0500X Pathology Cytopathology (Licence: SC 29526) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SC 29526) | |
| 207ZC0500X Pathology Cytopathology (Licence: MI 4301091934) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2016-10-10 |