| NPI | 1962867887 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 4698-320) | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS 444718) | 
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301505910) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OK 38247) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KS E-9770) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 69886) | |
| Enumeration Date | 2015-12-18 | 
| Last Update Date | 2024-10-24 |