| NPI | 1225037039 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 221535) | 
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: NY 221535) | 
| Enumeration Date | 2005-07-14 | 
| Last Update Date | 2025-05-13 |