| NPI | 1235301599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 65466) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MN 65466) |
| 207ZC0500X Pathology Cytopathology (Licence: MN 65466) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IA 37855) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301081483) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2022-08-18 |