| NPI | 1174919021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX S9416) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01089071A) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME138854) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-09-07 |