| NPI | 1912979204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD C173820) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MD D71393) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MD C173820) | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MN 46086) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2021-11-29 |