| NPI | 1053536771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZM0300X Pathology, Medical Microbiology (Licence: NY CQP28649) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NY LAP34974) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |