| NPI | 1487813747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID M2643) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: ID M2643) |
| 207ZF0201X Pathology, Forensic Pathology (Licence: WA MD00008798) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD00008798) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |