| NPI | 1083610802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME61735) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX J8202) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.045175) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2011-05-20 |