| NPI | 1295092583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME121731) |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: FL ME121731) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2024-01-17 |