| NPI | 1205273349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.142892) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: OH 35.142892) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2026-05-21 |