| NPI | 1417451634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 321047) |
| Additional Taxonomies | 207ZC0500X Pathology, Cytopathology (Licence: NY 321047) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-09-27 |