| NPI | 1730120049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 212898) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MA 212898) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-08-23 |