| NPI | 1114410875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: RI MD19925) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: CA A-177937) |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: CA A-177937) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-07-08 |