| NPI | 1275948127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: IN 01088583A) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MA 273737) |
| 208D00000X General Practice (Licence: ZZ 33128-1) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-01-04 |