| NPI | 1104819770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 139287) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NY 139287) |
| 207ZH0000X Pathology, Hematology (Licence: NY 139287) | |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2026-08-11 |