| NPI | 1003041849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NJ 25MA09992400) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NJ 25MA09992400) |
| 207ZC0500X Pathology Cytopathology (Licence: KY 47049) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 47049) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2024-08-06 |