| NPI | 1356362966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G25432) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: CA G25432) |
| 207ZD0900X Pathology Dermatopathology (Licence: CA G25432) | |
| 207ZH0000X Pathology Hematology (Licence: CA G25432) | |
| 207ZI0100X Pathology Immunopathology (Licence: CA G25432) | |
| 207ZM0300X Pathology Medical Microbiology (Licence: CA G25432) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: CA G25432) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2009-03-31 |