| NPI | 1932344785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TX N5391) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: TX N5391) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2011-08-24 |