| NPI | 1508969882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 12734) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA 27819) |
| 207ZP0104X Pathology, Chemical Pathology (Licence: NE 12734) | |
| 207ZP0104X Pathology, Chemical Pathology (Licence: IA 27819) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2013-12-17 |