| NPI | 1679676720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: VA 0101237705) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX L8416) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 36113473) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ 33944) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2013-11-27 |