| NPI | 1568889129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 323461) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: DC DO034544) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CT 69675) | |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2026-09-27 |