| NPI | 1225271174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 251874) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: PA MD463782) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 251874) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: PA MD463782) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2019-04-01 |