| NPI | 1801957402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: FL ME136664) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: CA G59467) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: CA G59467) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: FL ME136664) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2018-06-05 |