| NPI | 1073995130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61194470) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 11262207-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD206531) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WY 12800A) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 7516) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID M-15126) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2026-04-14 |