| NPI | 1538232681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: WV 24785) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 232956) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 232956) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-09-22 |