| NPI | 1639378250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01080360A) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL TRN11419) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME113183) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35.127659) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-12-03 |