NPI | 1750367546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA G27503) |
Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: CA G27503) |
Enumeration Date | 2005-12-22 |
Last Update Date | 2016-08-02 |