| NPI | 1689658361 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35043090B) | 
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.043090) | 
| Enumeration Date | 2005-12-06 | 
| Last Update Date | 2024-03-19 |