| NPI | 1326006305 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: MO 2004009613)  | 
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35-08-2510-s)  | 
| Enumeration Date | 2006-05-01 | 
| Last Update Date | 2025-09-11 |