| NPI | 1942284823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 35036312Q) |
| Additional Taxonomies | 207ZB0001X Pathology Blood Banking & Transfusion Medicine (Licence: OH 35036312Q) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2013-04-25 |