| NPI | 1780076869 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA OP61550669)  | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID OC-0461)  | 
| 207ZH0000X Pathology, Hematology (Licence: MT MEDPHYSCOMLIC140928)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 1581)  | |
| 207ZH0000X Pathology, Hematology (Licence: NE 1581)  | |
| 207ZH0000X Pathology, Hematology (Licence: OR DO219897)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MEDPHYSCOMLIC140928)  | |
| 207ZH0000X Pathology, Hematology (Licence: ID OC-0461)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR DO219897)  | |
| 207ZH0000X Pathology, Hematology (Licence: WA OP61550669)  | |
| 207ZH0000X Pathology, Hematology (Licence: CO CDRH.0065668)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK 222982)  | |
| 207ZH0000X Pathology, Hematology (Licence: AK 222982)  | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO CDRH.0065668)  | |
| Enumeration Date | 2015-02-25 | 
| Last Update Date | 2025-09-30 |