| NPI | 1326570649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL 46386) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: IN 01087605A) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-09-26 |