| NPI | 1922022854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL 39260) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: FL 39260) |
| 207ZH0000X Pathology Hematology (Licence: FL 39260) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2009-09-09 |