| NPI | 1194830984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 041875) |
| Additional Taxonomies | 207ZM0300X Pathology, Medical Microbiology (Licence: MI 041875) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-12-21 |