| NPI | 1093708653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: MD D66775) |
| Additional Taxonomies | 207ZP0101X Pathology Anatomic Pathology (Licence: NY 223046) |
| 207ZP0101X Pathology Anatomic Pathology (Licence: PA MD456689) | |
| 207ZP0101X Pathology Anatomic Pathology (Licence: MD D0066775) | |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2017-01-23 |