| NPI | 1700292505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME16309) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AL MD40956) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2023-11-02 |