| NPI | 1699918995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX R0949) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WY TL2563) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 27896) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2018-12-28 |