| NPI | 1841459625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 25318) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA 38613) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: HI MD14710) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD26766) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2016-01-27 |