| NPI | 1174793798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: UT 13328604-1205) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 231396) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: MA 231396) | |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2023-05-22 |