| NPI | 1619934817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MN 75607) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2020-04716) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35073783H) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2023-11-09 |