| NPI | 1386758571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301071732) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301071732) |
| 207ZC0500X Pathology, Cytopathology (Licence: MI 071732) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2026-01-07 |