| NPI | 1255316063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35-04-9493-K) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 33863) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX M0775) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD426508) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME92402) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2015-06-26 |