| NPI | 1437684230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WA MD61255703) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 10964552-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD61255703) | |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2025-04-14 |