| NPI | 1124097928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 306772) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NV 16365) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 141674) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: HI MD14371) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VT 042.0013934) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-10-16 |