| NPI | 1386758571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 071732) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 071732) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-12-21 |