| NPI | 1427635705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NY STREV1) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: NJ 25MS00021400) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-24 |