| NPI | 1285691469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 205935) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NJ 68509) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NJ 68509) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 205935) | |
| Enumeration Date | 2006-04-30 |
| Last Update Date | 2025-09-11 |