| NPI | 1669402707 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35-053169)  | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35-053169)  | 
| 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: OH 35-053169)  | |
| 207ZP0104X Pathology, Chemical Pathology (Licence: OH 35-053169)  | |
| 207ZC0006X Pathology, Clinical Pathology (Licence: OH 35-053169)  | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: OH 35-053169)  | |
| 207ZC0500X Pathology, Cytopathology (Licence: OH 35-053169)  | |
| 207ZD0900X Pathology, Dermatopathology (Licence: OH 35-053169)  | |
| 207ZF0201X Pathology, Forensic Pathology (Licence: OH 35-053169)  | |
| 207ZH0000X Pathology, Hematology (Licence: OH 35-053169)  | |
| 207ZI0100X Pathology, Immunopathology (Licence: OH 35-053169)  | |
| 207ZM0300X Pathology, Medical Microbiology (Licence: OH 35-053169)  | |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: OH 35-053169)  | |
| 207ZN0500X Pathology, Neuropathology (Licence: OH 35-053169)  | |
| 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35-053169)  | |
| Enumeration Date | 2006-07-04 | 
| Last Update Date | 2010-09-30 |