| NPI | 1508976457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 151326) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: NY 151326) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-07-03 |