| NPI | 1326006305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: OH 35-08-2510-S) |
| Additional Taxonomies | 207ZP0213X Pathology Pediatric Pathology (Licence: MO 2004009613) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |