| NPI | 1437474830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD444098) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 233360) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2015-01-15 |