| NPI | 1366634370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: ND 17519) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WI 53208-021) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CO 48679) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA OS015591) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2021-09-08 |