| NPI | 1003177049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME119481) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: FL ME119481) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 308297) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-08-18 |