| NPI | 1659360550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: VA 0101025334) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: VA 0101025334) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101025334) | |
| 207ZP0104X Pathology, Chemical Pathology (Licence: VA 0101025334) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: VA 0101025334) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2007-07-08 |