| NPI | 1245283118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: AZ 9503) |
| Additional Taxonomies | 207ZM0300X Pathology Medical Microbiology (Licence: AZ 9503) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ 9503) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-07-08 |