| NPI | 1083857791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 63194) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 63194) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 268534-1) | |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2022-03-31 |