| NPI | 1720898240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZF0201X Pathology Forensic Pathology (Licence: WI 55318-020) |
| Additional Taxonomies | 207ZF0201X Pathology Forensic Pathology (Licence: NY 227841) |
| 207ZF0201X Pathology Forensic Pathology (Licence: MI 4301072603) | |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |