| NPI | 1992935845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ME MD25289) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX Q6221) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 52297) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2022-01-05 |