| NPI | 1295014249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 293295) |
| Additional Taxonomies | 207ZD0900X Pathology, Dermatopathology (Licence: NY 293295) |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: NY 293295) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2019-06-20 |