| NPI | 1518933605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G54643) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: HI 8511) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WA 38955) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NV 11830) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-12-15 |