| NPI | 1518949288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO R7F78)  | 
| Additional Taxonomies | 207ZM0300X Pathology, Medical Microbiology (Licence: MO R7F78)  | 
| 207ZM0300X Pathology, Medical Microbiology (Licence: IL 036-104296)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036-104296)  | |
| Enumeration Date | 2005-11-17 | 
| Last Update Date | 2007-08-07 |