| NPI | 1013902675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: PR 7147) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: PR 7147) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2024-10-02 |