| NPI | 1972712784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301072457) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MI 4301072457) |
| 207ZC0500X Pathology, Cytopathology (Licence: MI 4301072457) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301072457) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-08-14 |