| NPI | 1891824272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2020023675) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: MO 2020023675) |
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: ID M-8200) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ID M-8200) | |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2022-09-12 |