| NPI | 1477511285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WA MD60095416) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: WA MD60095416) |
| 207ZC0500X Pathology Cytopathology (Licence: ID M-10794) | |
| 207ZC0500X Pathology Cytopathology (Licence: MT MEDPHYSLIC12185) | |
| 207ZC0500X Pathology Cytopathology (Licence: GA 49803) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: ID M-10794) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MT MEDPHYSLIC12185) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 49803) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2025-08-19 |