| NPI | 1548488505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 257335) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: TX BP10041604) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 001872) | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: NY 257335) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-11-30 |