| NPI | 1104038405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: PA MD435020) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NY 241463) |
| 207ZC0500X Pathology Cytopathology (Licence: PA MD435020) | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 241463) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-04-30 |