| NPI | 1346402294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 283291) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: NY 283291) |
| 207ZP0007X Pathology, Molecular Genetic Pathology (Licence: NY 283291) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2016-05-13 |