NPI | 1275948127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: IN 01088583A) |
Additional Taxonomies | 207ZC0006X Pathology Clinical Pathology (Licence: MA 273737) |
208D00000X General Practice (Licence: ZZ 33128-1) | |
Enumeration Date | 2014-06-29 |
Last Update Date | 2023-01-04 |