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 |