| NPI | 1346457256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301083130) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 41208) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301083130) | |
| 207ZF0201X Pathology, Forensic Pathology (Licence: MI 4301083130) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-08-21 |