| NPI | 1114168689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME119814) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 6779059-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M8309) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2022-05-03 |