| NPI | 1316115397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: TN 50645) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: MA 225429) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35097671) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD480134) | |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2025-01-14 |