| NPI | 1255655320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD LANCE EVANS Cmo 347-401-0161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 202320-1) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |