| NPI | 1215129283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35137124) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SD 7399) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: ND 11256) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-03-19 |