| NPI | 1679774137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0213X Pathology Pediatric Pathology (Licence: AZ 33439) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: AZ 33439) |
| 207ZC0500X Pathology Cytopathology (Licence: AZ 33439) | |
| 207ZD0900X Pathology Dermatopathology (Licence: AZ 33439) | |
| 207ZF0201X Pathology Forensic Pathology (Licence: AZ 33439) | |
| 207ZH0000X Pathology Hematology (Licence: AZ 33439) | |
| 207ZI0100X Pathology Immunopathology (Licence: AZ 33439) | |
| 207ZM0300X Pathology Medical Microbiology (Licence: AZ 33439) | |
| 207ZN0500X Pathology Neuropathology (Licence: AZ 33439) | |
| 207ZP0007X Pathology Molecular Genetic Pathology (Licence: AZ 33439) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ 33439) | |
| 207ZP0104X Pathology Chemical Pathology (Licence: AZ 33439) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2025-09-11 |