| NPI | 1770575938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology, Cytopathology (Licence: TX E9310) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX E9310) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2010-01-14 |