| NPI | 1518088954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: OR MD217565) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 264847) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2023-11-15 |