NPI | 1700950094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO DR.0061772) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MED-PHY-LIC-68985) |
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 32229) | |
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WY 12117A) | |
Enumeration Date | 2006-11-20 |
Last Update Date | 2020-03-24 |