| NPI | 1518967314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: PA OS003712L) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD003712L) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2008-03-04 |