| NPI | 1528258258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35.067412) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: AR E-5592) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2009-07-29 |