| NPI | 1225141146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 231220) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 213220) |
| 207ZF0201X Pathology, Forensic Pathology (Licence: NY 213220) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2009-10-14 |