| NPI | 1790849842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 30991) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN MD 013910) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 302249) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 18038) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME 45118) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01056379A) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2007-07-08 |