| NPI | 1992146500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: IL 036.1419) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: OH 57.022472) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2019-07-16 |