| NPI | 1639271471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: CA A74675) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A74675) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2024-03-13 |