| NPI | 1902064389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 56709) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 4541) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: GA 75748) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.094387) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 22066) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2018-03-17 |