| NPI | 1578705943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 0438181) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IN 01093069A) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY C3804) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2025-08-28 |