| NPI | 1225012529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: RI MD11067) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: CT 041072) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MA 219028) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: CA C50950) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: PA MD049356L) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: DE C10005211) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |