| NPI | 1699702373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: WI 60981) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: CO 45517) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: OH 097071) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: WV 24404) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: PA 065446-L) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2013-11-14 |