| NPI | 1205213402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZH0000X Pathology, Hematology (Licence: NJ 25MA10972200) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: NJ 25MA10972200) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 296282-1) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2024-05-03 |