| NPI | 1093993263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A109927) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: TX M6122) |
| 207ZP0007X Pathology Molecular Genetic Pathology (Licence: CA A109927) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX M6122) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: CA A109927) | |
| 291U00000X Clinical Medical Laboratory (Licence: CA A109927) | |
| 207ND0900X Dermatology Dermatopathology (Licence: CA A109927) | |
| 207SM0001X Medical Genetics Molecular Genetic Pathology (Licence: CA A109927) | |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2025-04-14 |