| NPI | 1972501708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 23194) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 47866) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME 86124) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA 36205) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SD 5544) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2023-01-17 |