| NPI | 1154573251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0007X Pathology Molecular Genetic Pathology (Licence: TX Q1360) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: MO 2008015640) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2022-09-19 |