| NPI | 1942290101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: MO R6P54) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: KS 0423998) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MO R6P54) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KS 0423998) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2007-07-08 |