| NPI | 1760707624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: WI 22408) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: IL 036.139961) |
| 207ZH0000X Pathology Hematology (Licence: IL 036.139961) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: ME MD21759) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 036.139961) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: MN 71488) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2022-06-14 |