| NPI | 1174502934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: KY 45600) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 99006) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35074920) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR MD156484) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2024-04-19 |