| NPI | 1841255122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 48559) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: WI 48559) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 55820) | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WI 48559) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-01-25 |