NPI | 1316915119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX J2746) |
Additional Taxonomies | 208D00000X General Practice (Licence: TX J2746) |
Enumeration Date | 2006-03-09 |
Last Update Date | 2024-01-17 |