| NPI | 1538296124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D68076) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 242497-1) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-01-25 |