| NPI | 1063018372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.153581) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA A166399) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2025-07-17 |