| NPI | 1245651009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD455020) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036151939) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2017014363) | |
| Enumeration Date | 2013-12-21 |
| Last Update Date | 2021-02-05 |