| NPI | 1912080235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 21531) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AK E-6450) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.202070) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL MD.28572) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2013-01-10 |