| NPI | 1336108349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: MO 36726) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: OH 35085815) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MI 4301090981) | |
| 207ZC0500X Pathology Cytopathology (Licence: MO 36726) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2016-04-06 |