| NPI | 1114332731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD485249) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: PA MD485249) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2025-05-19 |