| NPI | 1851502157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 52310) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 57009788) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 104382) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-08-17 |