| NPI | 1164640561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M2734) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: TX M2734) |
| 207ZH0000X Pathology, Hematology (Licence: IN 01060034A) | |
| 207ZH0000X Pathology, Hematology (Licence: FL ME 93293) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME 93293) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01060034A) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2022-03-09 |