| NPI | 1861475618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MO 2011005761) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MO 2011005761) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2014-03-26 |