| NPI | 1194795880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.087208) |
| Additional Taxonomies | 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: OR MD29197) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-01-10 |