| NPI | 1073791877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 1013922) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AZ 43249) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX L9493) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD0000042850) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 58932) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 43249) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 048547) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2023-09-12 |