| NPI | 1790999845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35096867) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL TRN14654) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA A97359) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 096867) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-02-16 |