| NPI | 1528176682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 160893) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: NY 160893) |
| 207ZC0500X Pathology, Cytopathology (Licence: NY 160893) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-03-21 |