| NPI | 1477637031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 168851-1) |
| Additional Taxonomies | 207ZH0000X Pathology, Hematology (Licence: NY 168851-1) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-02-20 |