| NPI | 1740925312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ R79295) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ 207ZP0102X) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |