| NPI | 1831143387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35.133020) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: RI MD10583) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.133020) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: RI MD10583) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-08-16 |