| NPI | 1528111598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology (Licence: PA OS008397L) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA 20A5450) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2021-01-15 |