| NPI | 1740281377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: FL ME 96672) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD068252L) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: FL ME 96672) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35.088499) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2017-02-06 |