| NPI | 1568448942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35-06-6756-S) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: OH 35066756S) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2016-07-14 |