| NPI | 1487844874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WA MD60483561) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 21257) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.203827) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2024-11-12 |