| NPI | 1184620080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 170806) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology (Licence: NY 170806) |
| 207ZD0900X Pathology Dermatopathology (Licence: NY 170806) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2013-10-24 |