| NPI | 1427801380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4351054495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.256534) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2025-06-22 |