| NPI | 1245331115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35.026509) |
| Additional Taxonomies | 207ZP0213X Pathology Pediatric Pathology (Licence: OH 35-02-6509) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2021-01-12 |