| NPI | 1306343801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: WI 68814-20) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WI 68814-20) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2022-10-11 |