| NPI | 1790951127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35.144160) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: OH 35.144160) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: FL ME124783) | |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: OH 35.144160) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD451133) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2026-07-07 |