| NPI | 1780076869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MT MEDPHYSCOMLIC140928) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: WA OP61550669) |
| 207ZH0000X Pathology, Hematology (Licence: CO CDRH.0065668) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR DO219897) | |
| 207ZH0000X Pathology, Hematology (Licence: MT MEDPHYSCOMLIC140928) | |
| 207ZH0000X Pathology, Hematology (Licence: ID OC-0461) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA OP61550669) | |
| 207ZH0000X Pathology, Hematology (Licence: AK 222982) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 1581) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CO CDRH.0065668) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID OC-0461) | |
| 207ZH0000X Pathology, Hematology (Licence: OR DO219897) | |
| 207ZH0000X Pathology, Hematology (Licence: NE 1581) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK 222982) | |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2026-06-24 |