| NPI | 1801976105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 44055) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.072415) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WI 38281-020) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-09-28 |