| NPI | 1043394695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE E BRANAM CEO 765-747-3428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01018004A) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: IN 01046076A) |
| 207ZH0000X Pathology, Hematology (Licence: IN 01018004A) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-12-17 |