| NPI | 1528645298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A192955) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: CA A192955) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-11-06 |