| NPI | 1740214154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN MD0000044516) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35-064195) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-03-16 |