| NPI | 1073734794 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 67958) | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VT 0600003440) | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301504318) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 99058473A) | |
| Enumeration Date | 2007-05-01 | 
| Last Update Date | 2022-11-15 |