| NPI | 1053725564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 1017354) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MO 2019032201) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2019032201) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2023-11-21 |