| NPI | 1750622643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 53677) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: AZ 53677) |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2021-11-12 |