| NPI | 1689714834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: WI 35629-020) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: WI 35629-020) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |