| NPI | 1942460662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: FL ME132667) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: MD D0074888) |
| 207ZC0500X Pathology, Cytopathology (Licence: MD D0074888) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MD D0074888) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2018-03-17 |