| NPI | 1871768820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA A90336) |
| Additional Taxonomies | 207ZD0900X Pathology Dermatopathology (Licence: CA A90336) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2021-06-14 |