# SELENE CLARISSA KOO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205122967
- **Gender:** F
- **Credential:** MD, PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 125059369 | IL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 35.132164 | OH | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 62776 | TN | — |
| 207ZP0213X | Pediatric Pathology Physician | 62776 | TN | Yes |

## Other

- **Enumeration date:** 06/21/2011
- **Last updated:** 02/13/2025