| NPI | 1144289596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35070641) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MI 4301091535) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2011-10-12 |