| NPI | 1093985103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME116850) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA PGY.1.LSUN-PATH) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2020-10-07 |