| NPI | 1487811675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZH0000X Pathology Hematology (Licence: MN 52243) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: MN 104379) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: OH 57.010498) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2020-10-06 |