| NPI | 1568583813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 238815-1) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 238815) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: NY 238815) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-09-22 |