| NPI | 1669882478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASSAN NICHOLAS SHAMMA Owner 937-602-4322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2015-04-01 |