| NPI | 1093079709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: ND 17572) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: UT 10212229-1205) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WI 70789) | |
| 208600000X Surgery (Licence: NE 6857) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-04-18 |