| NPI | 1346200433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 37505) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: KY 31401) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2013-11-25 |