| NPI | 1821595968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D97223) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: MD D0097223) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2025-01-07 |