| NPI | 1952415887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301051595) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: MI 4301051595) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-12-21 |