| NPI | 1063072668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 73737) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 320714-01) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 125075054) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2025-06-26 |