| NPI | 1114943263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35121319) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: OH 35 121319) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2017-12-12 |