| NPI | 1568560134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101258831) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: VA 0101258831) |
| 207ZC0006X Pathology Clinical Pathology (Licence: VA 0101258831) | |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: MD D0044362) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D0044362) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-12-11 |