| NPI | 1346205044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D46980) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: MD D46980) |
| 207ZC0500X Pathology, Cytopathology (Licence: MD D46980) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2025-12-10 |