| NPI | 1962867887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 69886) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS E-9770) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 38247) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 444718) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301505910) | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2023-06-07 |