| NPI | 1770826703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 3314) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 82730) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301103470) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 69314) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2024-02-08 |