| NPI | 1972542652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0006X Pathology Clinical Pathology (Licence: IA MD-45147) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: IA MD-45147) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MN 27655) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MD D50196) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2018-05-08 |