| NPI | 1922156637 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301032753) | 
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: MI 4301032753) | 
| Enumeration Date | 2007-01-08 | 
| Last Update Date | 2025-09-11 |