| NPI | 1912780107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA MTA-00044276) |
| Additional Taxonomies | 207ZP0007X Pathology Molecular Genetic Pathology (Licence: CA MTA-00044276) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |