| NPI | 1366838443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A155128) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A155128) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-02-11 |