| NPI | 1750412359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2011020508) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MO 2011020508) |
| 207ZC0500X Pathology, Cytopathology (Licence: IL 36091321) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: IL 36091321) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 36091321) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2021-02-18 |