| NPI | 1306999370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: MN 48433) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 48433) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2026-04-01 |