| NPI | 1912982646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35063701J) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: OH 35063701) |
| 207ZH0000X Pathology, Hematology (Licence: OH 35063701) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-09-03 |