| NPI | 1225392715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 307882) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT 202895) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2024-04-15 |