| NPI | 1669861829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology, Forensic Pathology (Licence: GA 51874) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: SC 15063) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 51874) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 15063) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 17880) | |
| 207ZF0201X Pathology, Forensic Pathology (Licence: AL 17880) | |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2023-05-04 |