| NPI | 1598905689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N6992) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 244175) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2013-11-21 |