| NPI | 1356543441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 2OA8899) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 005451) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-06-02 |