| NPI | 1104038405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD435020) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: PA MD435020) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 30072) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.127719) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2025-03-05 |