| NPI | 1427034495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: TX L8923) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: OH 34-008443) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: GA 056474) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: NC 2005-00398) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: CA 20A8161) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2024-02-01 |