| NPI | 1700839255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AL 25019) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: AL 25019) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-04-23 |