| NPI | 1245269000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO DR.0041989) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: UT 5857232-1205) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NE 24534) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WY 7550A) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-03-24 |