| NPI | 1780628313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA IMLC.MD.61277913) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK 192330) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 46633) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD40440) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2022-06-14 |