| NPI | 1780842609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A83490) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: KS 32967) |
| 207ZD0900X Pathology, Dermatopathology (Licence: KS 32967) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: KS 32967) | |
| 207ZC0500X Pathology, Cytopathology (Licence: CA A83490) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: CA A83490) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2013-01-03 |