| NPI | 1194723924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: SD 2710) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 18482) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 47381) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NC 20077) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE 23096) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 101022782) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2013-02-25 |