| NPI | 1174969356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A168866) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: CA A168866) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2026-07-14 |