| NPI | 1972585586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0008X Pathology, Clinical Informatics Specialist (Licence: FL 111484) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: FL S99264) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35.129581) | |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: FL 111484) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL 97007) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: FL 111484) | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35.129581) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2022-08-19 |