| NPI | 1427048925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DE C1-0007068) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: DE C1-0007068) |
| 207ZM0300X Pathology, Medical Microbiology (Licence: DE C1-0007068) | |
| 207ZC0500X Pathology, Cytopathology (Licence: DE C1-0007068) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-04-08 |