| NPI | 1992013635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C30639) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: CA C30639) |
| 207ZC0006X Pathology, Clinical Pathology (Licence: CA C30639) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |