| NPI | 1588778765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 71906) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME168148) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MI 084836) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2024-11-26 |