| NPI | 1447781216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 72939) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME162421) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2025-06-10 |