| NPI | 1144478249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: PR 17856) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: FL ME130345) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 48584) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2020-02-18 |