| NPI | 1528289915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.090909) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: OH 35.090909) |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35.090909) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-12-14 |