| NPI | 1851317465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 51410) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO 2001011449) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 04-29273) | |
| 207ZD0900X Pathology Dermatopathology (Licence: TN 51410) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2024-11-22 |