| NPI | 1285697771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZC0500X Pathology Cytopathology (Licence: NY 17155-1) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: NY 177155-1) |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: NY 177155-1) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2007-07-08 |