| NPI | 1255344461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 301680) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 209653) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: FL ME107163) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 301680) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2024-08-09 |