| NPI | 1114243391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.131468) |
| Additional Taxonomies | 207ZN0500X Pathology, Neuropathology (Licence: OH 35.131468) |
| 207ZC0500X Pathology, Cytopathology (Licence: OH 35.131468) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2026-05-21 |