| NPI | 1700012689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 1019015) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: KY 48650) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 036151239) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME157217) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35.148216) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2024-04-23 |