| NPI | 1184627028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: MA 49024) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 49024) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2025-09-11 |