| NPI | 1154314185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 114226) |
| Additional Taxonomies | 207ZP0007X Pathology Molecular Genetic Pathology (Licence: NY 114226) |
| 207ZP0213X Pathology Pediatric Pathology (Licence: NY 114226) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-09-12 |