NPI | 1578976817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 303640) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: RI LP03167) |
Enumeration Date | 2014-06-04 |
Last Update Date | 2023-12-27 |