| NPI | 1942213566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: VA 0101047754) |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: VA 0101047754) |
| 207ZC0500X Pathology, Cytopathology (Licence: VA 0101047754) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-12-28 |