| NPI | 1366514218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 61347) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 4301093613) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 109301) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301093613) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 225901) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-10-06 |