| NPI | 1114902921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M1195) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35-05-4943-L) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 34034) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD421442) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME90714) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2018-03-27 |