| NPI | 1558650283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35C.003541) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MI 4301099303) |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: OH 35C.003541) | |
| 207ZC0500X Pathology, Cytopathology (Licence: OH 35C.003541) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2026-02-04 |