| NPI | 1306077557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35099283) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: OH 35099283) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2016-08-25 |