| NPI | 1962559021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 149417) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: CA 149417) |
| 207ZN0500X Pathology Neuropathology (Licence: CA 149417) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-07-21 |